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Pachi A, Sikaras C, Melas D, Alikanioti S, Soultanis N, Ivanidou M, Ilias I, Tselebis A. Stress, Anxiety and Depressive Symptoms, Burnout and Insomnia Among Greek Nurses One Year After the End of the Pandemic: A Moderated Chain Mediation Model. J Clin Med 2025; 14:1145. [PMID: 40004676 PMCID: PMC11856992 DOI: 10.3390/jcm14041145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 02/01/2025] [Accepted: 02/07/2025] [Indexed: 02/27/2025] Open
Abstract
Background/Objectives: Several studies have reported alarming rates of mental health issues and sleep problems among nurses even in the post-pandemic era. The objective was to investigate the prevalence of stress, anxiety and depressive symptoms, burnout and insomnia among nurses in Greece one year after the end of the pandemic and to construct a mediation model evaluating the impact of stress on insomnia, the chain mediating roles of depressive symptoms and burnout, as well as the moderating role of anxiety symptoms in the model. Methods: This cross-sectional study was conducted online in July 2024 and included 380 hospital nurses who completed the Depression Anxiety Stress Scale (DASS-21), the Copenhagen Burnout Inventory (CBI) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of stress, anxiety and depressive symptoms, burnout and insomnia were 33.9% with 95% confidence interval (CI): [0.292, 0.390], 33.3% (95% CI: [0.284, 0.381]), 35% (95% CI: [0.302, 0.400]), 46.8% (95% CI: [0.399, 0.502]) and 56.1% (95% CI: [0.509, 0.611]), respectively. Multiple regression analysis indicated that the Depression subscale of the DASS-21 explained 40.6% of the variance in the AIS, while an additional 7.6% was explained by the CBI and another 1.3% rate by the Stress subscale of the DASS-21. Mediation analysis revealed that stress affected insomnia both directly and indirectly through the chain mediating roles of depressive symptoms and burnout. Anxiety symptoms moderated the chain mediation path by enhancing the negative impact of stress on depressive symptoms. Conclusions: The proposed moderated chain mediation model introduces certain factors influencing insomnia and explains how changes in any one of these factors effectuate changes in the other factors, offering insights for individualized interventions.
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Affiliation(s)
- Argyro Pachi
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (A.P.); (D.M.); (S.A.); (N.S.); (M.I.)
| | - Christos Sikaras
- Nursing Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece;
| | - Dimitrios Melas
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (A.P.); (D.M.); (S.A.); (N.S.); (M.I.)
| | - Sofia Alikanioti
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (A.P.); (D.M.); (S.A.); (N.S.); (M.I.)
| | - Nikolaos Soultanis
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (A.P.); (D.M.); (S.A.); (N.S.); (M.I.)
| | - Maria Ivanidou
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (A.P.); (D.M.); (S.A.); (N.S.); (M.I.)
| | - Ioannis Ilias
- Department of Endocrinology, Hippocration General Hospital of Athens, 11527 Athens, Greece;
| | - Athanasios Tselebis
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece; (A.P.); (D.M.); (S.A.); (N.S.); (M.I.)
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Juanamasta IG, Aungsuroch Y, Gunawan J, Dino MJ, Polsook R. Prevalence of burnout and its determinants among Indonesian nurses: a multicentre study. Sci Rep 2024; 14:31559. [PMID: 39738096 PMCID: PMC11685480 DOI: 10.1038/s41598-024-63550-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 05/30/2024] [Indexed: 01/01/2025] Open
Abstract
Frontline health workers face a significant issue concerning mental health, particularly stress and burnout. Nurses, being among them, grapple with this problem. The study aims to investigate the prevalence and determinants of burnout among nurses. A multicenter cross-sectional study was conducted across twenty two hospitals. A total of nine hundred nurses participated through convenience sampling. Burnout was measured using a single-measurement approach. Both individual and unit-related factors were examined. Over half of the nurses experienced stress, while 7.3% had symptoms of exhaustion. One in every hundred nurses faced a high likelihood of experiencing complete burnout. Job satisfaction, basic salary, motivation, age, incentives, competence, extra responsibilities, and knowledge of quality emerged as significant predictors of burnout. Addressing burnout among nurses requires hospitals to improve job satisfaction, revisit salaries, and foster supportive environments with incentives. Tailored training and ongoing support are crucial for resilience. Prioritizing these strategies is vital for nurses' well-being and sustainable healthcare delivery.
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Affiliation(s)
- I Gede Juanamasta
- Faculty of Nursing, Chulalongkorn University, Borommaratchachonnani Srisataphat, Building, Rama 1 Road, Pathumwan, 10330, Bangkok, Thailand
| | - Yupin Aungsuroch
- Faculty of Nursing, Chulalongkorn University, Borommaratchachonnani Srisataphat, Building, Rama 1 Road, Pathumwan, 10330, Bangkok, Thailand.
| | - Joko Gunawan
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Michael Joseph Dino
- Research Development and Innovation Centre, Our Lady Fatima University, Valenzuela, Philippines
| | - Rapin Polsook
- Faculty of Nursing, Chulalongkorn University, Borommaratchachonnani Srisataphat, Building, Rama 1 Road, Pathumwan, 10330, Bangkok, Thailand.
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Sela Y, Grinberg K, Halevi Hochwald I. Exploring client violence during home visits: a qualitative study of perceptions and experiences of Israeli nurses. Isr J Health Policy Res 2024; 13:53. [PMID: 39334503 PMCID: PMC11429182 DOI: 10.1186/s13584-024-00640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Home care provides an excellent opportunity for personalizing treatment as nurses see patients in their natural environment. Along with its many advantages, the home care environment carries unique risks, as nurses are usually alone, without the protection and security provided by primary care clinics. There are no accurate data in Israel on the scope and characteristics of client violence against nurses during home visits. We conducted a qualitative study to investigate the nature of client violence faced by Israeli nurses during home visits, to gain insights into their perceptions and experiences, and to contribute to the development of effective policies and strategies to combat client violence in the healthcare sector. METHODS Twenty-seven female nurses from primary care clinics, who were exposed to client violence during a home visit, were interviewed using a semi-structured interview guide. The interviews were transcribed and analyzed, and categories and themes were extracted. RESULTS Most nurses interviewed experienced at least three incidents of client violence, the most common of which was verbal abuse. The nurses perceived that the location of the encounter between the nurse and the patient in the patient's natural surroundings, rather than within the controlled boundaries of a clinic, contributes to the risk of violence. Violence affected the nurses' professional decisions. The nurses reported that their organization had no established guidelines or instructions for safely conducting home visits, they were not provided with protective or security measures for emergencies, nor did they perceive that they had sufficient training to deal with client violence in clients' homes. CONCLUSIONS Nurses encounter a range of challenges that make it difficult for them to deal with client violence during home visits, affecting their personal safety and professional decisions. Their ability to manage such situations is shaped by a complex interplay of personal and organizational factors and requires a range of strategies and resources to effectively address them.
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Affiliation(s)
- Yael Sela
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center , Emeq Hefer, Israel.
- Community Nurse, Maccabi Healthcare Services, HaSharon District, Israel.
| | - Keren Grinberg
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center , Emeq Hefer, Israel
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Cai Y, Liu M, Li Y, Li J, Geng J, Liu X, Zhang J. Secondary traumatic stress and vicarious posttraumatic growth in oncology nurses: the mediating role of empathy. Front Public Health 2024; 12:1454998. [PMID: 39354994 PMCID: PMC11442218 DOI: 10.3389/fpubh.2024.1454998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 09/02/2024] [Indexed: 10/03/2024] Open
Abstract
Background The relationship between secondary traumatic stress (STS), empathy, and vicarious post-traumatic growth (VPTG) in oncology nurses is unclear. Understanding these links is crucial for improving nurse well-being and patient care quality. Objective This study aimed to investigate the relationships between STS, empathy, and VPTG among oncology nurses. Methods This cross-sectional study was conducted in a multicentric setting. Data collection involved oncology nurses completing questionnaires assessing STS, empathy, and VPTG levels. Data analysis included correlation analyses, multiple stepwise regression analysis, and structural equation modeling (SEM) to examine the interrelationships between these variables. The study adhered to the STROBE checklist. Results A total of 391 oncology nurses participated in the study. They showed moderate to low levels of VPTG and high levels of STS. STS exhibited a negative association with VPTG, while empathy demonstrated a positive direct association with both VPTG and STS. Moreover, SEM indicated that empathy mediated the relationship between STS and VPTG, with a partial mediating effect of 0.127. Factors such as receiving psychological training, educational attainment, STS, and empathy collectively explained 24% of the variance in VPTG. Conclusion Our findings highlighted the negative correlation between STS and VPTG among oncology nurses. Additionally, empathy was found to mediate the relationship between STS and VPTG, suggesting it plays a significant role in influencing VPTG. Implications for practice To aid oncology nurses, interventions should focus on reducing STS and enhancing empathy. Strategies like resilience workshops, peer support, and stress management can foster VPTG. Creating a supportive work environment is crucial for nurses' well-being and quality patient care.
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Affiliation(s)
- Yitong Cai
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Ming Liu
- Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
| | - Yifei Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Juan Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jie Geng
- Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xiaoying Liu
- Department of Gynecologic Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Hjörleifsdóttir E, Sigurðardóttir Þ, Óskarsson GK, Halapi EC. Stress, burnout and coping among nurses working on acute medical wards and in the community: A quantitative study. Scand J Caring Sci 2024; 38:636-647. [PMID: 38977380 DOI: 10.1111/scs.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/23/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Psychological distress can cause burnout, which affects mental and physical well-being. It is important to identify factors associated with psychological distress and physical discomfort and how nurses deal with these problems. AIM The aim was to investigate distress, burnout and coping among community nurses (CN) and hospital nurses (HN). APPROACH AND METHODS In this cross-sectional study, 409 nurses completed three questionnaires: Perceived Stress Scale (PSS), Copenhagen Burnout Inventory (CBI) and Ways of Coping (WOC). FINDINGS Participants younger than 40 demonstrated significantly more distress and burnout than those older than 40 years. Participants who had moderate and high distress on the PSS were significantly more at risk for experiencing personal, work-related and patient-related burnout. A significant positive correlation was found between distress and behavioural escape-avoidance, cognitive escape-avoidance and distancing. Significant positive correlations were also seen between all the subscales of the CBI and behavioural escape-avoidance, cognitive escape-avoidance and distancing. Positive significant correlation was also obtained between staff resources and distress and personal-related and work-related burnout. Negative correlation was demonstrated between staff resources and patient-related burnout. Participants with longer work experience were less likely to report moderate or high distress, and those who scored higher on personal burnout and behavioural escape-avoidance were more likely to have moderate or high distress. CONCLUSION The results of this study call for increased attention to the younger generation in the nursing profession. The results also validate the need to investigate further the correlation between distress, burnout and coping and how these issues might influence each other among nurses working in the community and hospitals. Findings should be taken with precaution, they do not describe in detail what underlying factors contribute to distress and discomfort found in this study, they do, however, indicate certain coping strategies nurses use to deal with distress and burnout.
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Affiliation(s)
| | - Þórhalla Sigurðardóttir
- Accident and Emergency Nursing, School of Health, Business and Natural Sciences-Faculty of Nursing, University of Akureyri, Akureyri, Iceland
| | | | - Eva Charlotte Halapi
- School of Health, Business and Natural Sciences-Faculty of Nursing, University of Akureyri, Akureyri, Iceland
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Mitchell LM, Anand A, Muke S, Hollon SD, Joshi U, Khan A, Haney JR, Shrivastava R, Singh A, Singla DR, Teja GS, Tugnawat D, Bhan A, Patel V, Naslund JA. Burnout, motivation and job satisfaction among community health workers recruited for a depression training in Madhya Pradesh, India: a cross-sectional study. BMJ PUBLIC HEALTH 2024; 2:e001257. [PMID: 39641101 PMCID: PMC11619649 DOI: 10.1136/bmjph-2024-001257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2024]
Abstract
Introduction Burnout, low motivation, and poor job satisfaction among community health workers (CHWs) have negative impacts on health workers and on patients. This study aimed to characterize levels of burnout, motivation, and job satisfaction in CHWs in Madhya Pradesh, India and to determine the relation between these levels and participant characteristics. This study can inform efforts to promote wellbeing and address stress in this population. Methods In this cross-sectional study, we recruited participants via simple random sampling without replacement. We administered two validated questionnaires, the Copenhagen Burnout Inventory and a Motivation and Job Satisfaction Assessment, to CHWs who had enrolled in a training program to deliver a brief psychological intervention for depression. We calculated mean scores for each questionnaire item, examined the reliability of the measures, and analyzed associations between participant demographic characteristics and questionnaire scores. Results 339 CHWs completed the questionnaires. The personal burnout domain had the highest mean burnout score (41.08, 95% CI 39.52-42.64, scale 0-100) and 33% of participants reported moderate or greater levels of personal burnout. Items that reflected physical exhaustion had the highest item-test correlations. The organization commitment domain had the highest mean motivation score (mean 3.34, 95% CI 3.28 - 3.40, scale 1-4). Items describing pride in CHWs' work had the highest item-test correlations. Several pairwise comparisons showed that higher education levels were associated with higher motivation levels (degree or higher vs. 8th standard [p=0.0044] and 10th standard [p=0.048], and 12th standard vs. 8th standard [p= 0.012]). Cronbach's alpha was 0.82 for the burnout questionnaire and 0.86 for the motivation and job satisfaction questionnaire. Conclusion CHWs report experiencing burnout and feeling physically tired and worn out. A sense of pride in their work appears to contribute to motivation. These findings can inform efforts to address burnout and implement effective task-sharing programs in low-resource settings.
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Affiliation(s)
- Lauren M Mitchell
- University of Chicago Division of the Biological Sciences, Section of General Internal Medicine, University of Chicago, Chicago, IL, USA
| | | | | | - Steven D Hollon
- Vanderbilt University, Department of Psychology, Nashville, TN, USA
| | | | - Azaz Khan
- Sangath, Bhopal, Madhya Pradesh, India
| | | | | | | | - Daisy R Singla
- University of Toronto Temerty Faculty of Medicine, Department of Psychiatry, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | | | | | - Vikram Patel
- Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA
- Harvard University T.H. Chan School of Public Health, Department of Global Health and Population, Boston, MA, USA
| | - John A Naslund
- Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA
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Maddigan J, Brennan M, McNaughton K, White G, Snow N. The Prevalence and Predictors of Compassion Satisfaction, Burnout and Secondary Traumatic Stress in Registered Nurses in an Eastern Canadian Province: A Cross-Sectional Study. Can J Nurs Res 2023; 55:425-436. [PMID: 36694930 PMCID: PMC10619188 DOI: 10.1177/08445621221150297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The quality of Registered Nurses' worklife is impacting nurses' mental health, and the standard of care received by clients. Contributing factors to nurses' stress are the trauma of continuous caring for those in great suffering, and adverse working conditions. OBJECTIVES i) to explore the prevalence of work-related stress in a provincial sample of Registered Nurses; ii) to compare the levels of compassion satisfaction, burnout and secondary traumatic stress reported by nurses in hospital, community, non-direct care settings, and, iii) to identify factors that predict levels of nursing work stress. METHODS A descriptive, predictive study with a self-report survey containing demographic questions and the Professional Quality of Life Scale was emailed to over 3,300 Registered Nurses. The scale measured the prevalence of three worklife indicators, compassion satisfaction, burnout and secondary traumatic stress. Multiple linear regression identified factors that predicted the levels of the three indicators. A subgroup analysis explored the quality of worklife based on three practice environments. FINDINGS Nurses (n = 661) reported moderate compassion satisfaction, burnout, and secondary traumatic stress. The strongest predictor, satisfaction with one's current job, predicted high compassion satisfaction and lower burnout and secondary stress. The subgroup analysis identified hospital nurses as having the most work-related stress and the lowest level of compassion satisfaction. CONCLUSION Innovative, collaborative action can transform nurses' practice environments. Organizational support is essential to bring about needed improvements.
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Affiliation(s)
- Joy Maddigan
- Faculty of Nursing, Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
| | - Maureen Brennan
- Organizational Development, Eastern Regional Health Authority, St. John's, NL, Canada
| | - Kelly McNaughton
- Peer Support and Trauma Response Program, Toronto Hospital for Sick Kids, Toronto, ON, Canada
| | - Gerry White
- Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
| | - Nicole Snow
- Faculty of Nursing, Memorial University of Newfoundland and Labrador, St. John's, NL, Canada
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Paustian-Underdahl SC, Halbesleben JRB, Carlson DS, Hamadi HY. Examining regulatory focus in the acceleration and deceleration of engagement and exhaustion cycles among nurses. Health Care Manage Rev 2023; 48:282-290. [PMID: 37192154 DOI: 10.1097/hmr.0000000000000375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Given that emotional exhaustion and nurse engagement have significant implications for nurse well-being and organizational performance, determining how to increase nurse engagement while reducing nurse exhaustion is of value. PURPOSE Resource loss and gain cycles, as theorized in conservation of resources theory, are examined using the experience of emotional exhaustion to evaluate loss cycles and work engagement to evaluate gain cycles. Furthermore, we integrate conservation of resources theory with regulatory focus theory to examine how the ways in which individuals approach work goals serves as a facilitator to the acceleration and deceleration of both of these cycles. METHODOLOGY/APPROACH Using data from nurses working in a hospital in the Midwest United States at six time points spanning over 2 years, we demonstrate the accumulation effects of the cycles over time using latent change score modeling. RESULTS We found that prevention focus was associated with the accelerated accumulation effects of emotional exhaustion and that promotion focus was associated with the accelerated accumulation effects of work engagement. Furthermore, prevention focus attenuated the acceleration of engagement, but promotion did not influence the acceleration of exhaustion. CONCLUSION Our findings suggest that individual factors such as regulatory focus are key to helping nurses to better control their resource gain and loss cycles. PRACTICE IMPLICATIONS We provide implications for nurse managers and health care administrators to help encourage promotion focus and suppress prevention focus in the workplace.
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Cui Y, Yang T, Zhang M, Liu N, Liu Q, Zhang L, Zhang L, Yang H, Zhang Y. Influence of empathy on work alienation among Chinese nurses during the COVID-19 pandemic: The mediating effect of ego depletion. Front Psychol 2023; 14:1057460. [PMID: 36818075 PMCID: PMC9932043 DOI: 10.3389/fpsyg.2023.1057460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
Background Nurses' work alienation has become increasingly serious due to the increase in workload and risk during the coronavirus disease 2019 (COVID-19). However, no studies have investigated the link between empathy, ego depletion, and work alienation among Chinese nurses. The present study aimed to evaluate Chinese nurses' empathy, ego depletion, and work alienation and to examine whether nurses' ego depletion mediates the relationship between empathy and work alienation. Methods This was a descriptive, cross-sectional study involving 353 nurses from Shaanxi. The Jefferson Scale of Empathy-Health Professionals, Self-Regulating Fatigue Scale and Work Alienation Questionnaire were used to collect data through an online survey. Structural equation modeling was conducted to analyze the mediating model. Results Work alienation was negatively correlated with empathy (r = -0.305, p < 0.01) and positively correlated with ego depletion (r = 0.652, p < 0.01). Empathy was negatively correlated with ego depletion (r = -0.325, p < 0.01). Empathy can directly predict work alienation (β = -0.263, p < 0.01), while ego depletion has a mediating effect between empathy and work alienation (β = -0.309, p < 0.01), and the mediating effect accounts for 54.02% of the total effect. Conclusion Nurses' work alienation was at a moderate-to-high level. Improving empathy can reduce work alienation through less ego depletion. Nursing managers should discover nurses' work alienation as soon as possible. Interventions to improve empathy can help replenish nurses' psychological resources, thereby reducing ego depletion and work alienation.
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Affiliation(s)
- Yi Cui
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Man Zhang
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Na Liu
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Qin Liu
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Lanfang Zhang
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Lihua Zhang
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Haoshuang Yang
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Yinling Zhang
- Department of Nursing, Air Force Medical University, Xi’an, China,*Correspondence: Yinling Zhang, ✉
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Karvouni L, Adamakidou T, Mantzorou M, Mantoudi A, Christopoulos D, Fasoi G, Zartaloudi A. Job Satisfaction of Nurses Versus Other Mental Health Professionals Working in Psychosocial Rehabilitation Services. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:247-256. [PMID: 37581798 DOI: 10.1007/978-3-031-31986-0_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
INTRODUCTION The objectives of Psychiatric Reform were, on the one hand, psychiatric hospitals' shutting down and, on the other hand, the creation of Psychosocial Rehabilitation facilities, in order to provide appropriate care to individuals suffering from mental health problems in community. Therefore, mental health professionals' job satisfaction constitutes one of the fundamental factors leading either to success or failure of each reforming effort. PURPOSE The aim of this study was to investigate the level of professional satisfaction of nurses working in Psychosocial Rehabilitation facilities compared to other mental health professionals. METHODOLOGY Three hundred and sixty-seven mental health professionals, working in the field of psychosocial rehabilitation completed (a) a sociodemographic questionnaire, and (b) Spectοr's Job Satisfaction Survey (JSS). RESULTS Moderate levels of total professional satisfaction were observed. Low satisfaction rates were recorded in "Pay," "Promotion," and "Fringe Benefits" subscale. High satisfaction rates were recorded in "Supervision," "Cooperation between colleagues," and "Nature of work," while moderate satisfaction rates were reported in "Contingent rewards," "Operating procedures," and "Communication" within facilities. It is noteworthy that nurses were statistically significant less satisfied with the "Contingent rewards" (p = 0.028), the "Nature of work" (p = 0.001), and the "Communication" (p = 0.019), while they were statistically significant more satisfied with "Supervision" (p = 0.007) compared to the other specialties of mental health professionals. CONCLUSIONS The results can be used by those with administrative and scientific responsibilities in the field of mental health in order to recognize professionals' difficulties and solve their problems in psychosocial rehabilitation facilities. These interventions could improve their levels of job satisfaction, in order to achieve optimal therapeutic results for mentally ill and improve the quality of the services provided.
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Affiliation(s)
- Loukia Karvouni
- Department of Nursing, University of West Attica, Athens, Greece
| | | | | | | | | | - Georgia Fasoi
- Department of Nursing, University of West Attica, Athens, Greece
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Lee WL, Rambiar PNIMS, Rosli NQB, Nurumal MS, Abdullah SSS, Danaee M. Impact of increased digital use and internet gaming on nursing students' empathy: A cross-sectional study. NURSE EDUCATION TODAY 2022; 119:105563. [PMID: 36150294 DOI: 10.1016/j.nedt.2022.105563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/22/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 restrictions and quarantines had led to increased dependence and usage of digital devices for various human activities and internet gaming to the extent of risking vulnerable individuals to develop addiction towards it. Little is known on such risks among populations of nursing students and its impact on their empathy skills or trait. OBJECTIVE Determining the impact of digital use and internet gaming on empathy of nursing students undergoing remote learning during closure of learning institutions nationwide. DESIGN Cross-sectional online survey was conducted from October to December 2020. SETTINGS Two established public institutions located in Malaysia. PARTICIPANTS A total of 345 nursing students pursuing diploma and bachelor nursing programs. METHODS Toronto Empathy Questionnaire (TEQ), Digital Addiction Scale (DAS) and Internet Gaming Disorder Scale-Short form (IGDS9-SF) were self-administered via Google Form™. Following principal component analysis of TEQ using IBM-SPSS™ (V-27), path analyses was performed using SmartPLS™ (V-3). RESULTS Despite the increased time spent on digital devices (∆ 2.8 h/day) and internet gaming (∆ 1 h/week) before and during the pandemic, the proportion of high digital users (1.4 %) and gamers (20.9 %) were low; and sizable ≈75 % had higher-than-normal empathy. Digital-related emotions and overuse of them were associated with lower empathy (β = -0.111, -0.192; p values < 0.05) and higher callousness (β = 0.181, 0.131; p values < 0.05); internet gaming addiction predicted callousness (β = 0.265, p < 0.001) but digital dependence correlated with higher empathy (β = 0.172, p = 0.009). CONCLUSIONS Digital and internet gaming addiction potentially impact empathy. The negative impact of digital dependence can be attenuated by "digital empathy" - an emerging phenomenon becoming increasingly vital in digital health and communication.
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Affiliation(s)
- Wan Ling Lee
- Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | | | | | - Mohd Said Nurumal
- Kulliyyah of Nursing, International Islamic University Malaysia, 25200 Kuantan, Malaysia.
| | - Sharifah Shafinaz Sh Abdullah
- Centre for Nursing Studies, Faculty of Health Sciences, Puncak Alam Campus, Universiti Teknologi MARA, 42300, Selangor, Malaysia.
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Innes SI, Simpson JK. Empathy levels in Australian chiropractic students. THE JOURNAL OF CHIROPRACTIC EDUCATION 2022; 36:110-116. [PMID: 35294012 PMCID: PMC9536223 DOI: 10.7899/jce-21-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/12/2021] [Accepted: 09/13/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Empathy is an important modifiable quality of health care practitioners that relates to the quality of patient care. The educative process may adversely affect the empathy levels of health care students at key phases of training. This topic remains unexplored in chiropractic students to date. METHODS A voluntary and anonymous questionnaire was distributed to all chiropractic students in an Australian university-based program in April 2021. This questionnaire recorded age, sex, year of study, and Toronto Empathy Questionnaire scores. RESULTS Chiropractic student empathy scores approximated those of other Australian health care students. No statistical differences were found when comparing the mean scores of empathy levels across the 5 student cohorts. The empathy levels of female chiropractic students' were significantly higher than those of the male chiropractic students. CONCLUSION This study provides a baseline from which further explorations on empathy may be conducted in chiropractic students. This holds the potential to improve practitioners' quality of life and patient outcomes and for educators to identify subject matter that may negatively affect empathy levels.
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Peabody J, Lucas A, Ziesmann MT, Gillman LM. A cross-sectional study evaluating the relationship between followership type and burnout amongst critical care followers. Intensive Crit Care Nurs 2022; 72:103275. [DOI: 10.1016/j.iccn.2022.103275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
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Challenges faced by Chinese community nurses when providing home-based hospice and palliative care: a descriptive qualitative study. BMC Palliat Care 2022; 21:14. [PMID: 35105360 PMCID: PMC8805229 DOI: 10.1186/s12904-022-00905-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Hospital facilities in China are experiencing increased strain on existing systems and medical resources, necessitating the use of home-based hospice and palliative care (HBHPC). HBHPC primarily relies on community nurses and related medical personnel. Understanding the challenges that community nurses face when providing this form of care is urgently needed to optimize the design and delivery of HBHPC. Our study aimed to gain insight into community nurses’ challenges when providing HBHPC for patients. Methods We performed a descriptive qualitative study using a phenomenology approach. Purposive sampling was used to recruit 13 nurses from two community health service centers in Jinan, Shandong Province, China. A thematic analysis was applied to identify themes from the transcribed data. Results Three major themes emerged: 1) Community nurses’ inadequate self-preparation for providing HBHPC; 2) Patients and their families’ non-collaboration in HBHPC; 3) Community health service career disadvantages. Many negative experiences can be attributed to institutional barriers. Conclusion Community nurses faced multifaceted challenges in home care settings. This study could provide a framework for guiding the improvement of interventional variables in the provision of HBHPC. Future research should involve developing effective methods of improving community nurses’ job motivation and community health service institutions’ incentive systems, as well as increasing advocacy around HBHPC.
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15
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Gustavsson K, Jernajczyk W, Wichniak A. Insomnia Partially Mediates the Relationship of Occupational Stress with Mental Health Among Shift Working Nurses and Midwives in Polish Hospitals. Nat Sci Sleep 2022; 14:1989-1999. [PMID: 36353570 PMCID: PMC9639594 DOI: 10.2147/nss.s375375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/11/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Insufficient sleep increases sensitivity to chronic stress and may be a precursor to the deterioration of mental health and the development of burnout. The aim of our study was to verify whether symptoms of insomnia mediate the relationship of occupational stress with mental health among nurses who work shifts. MATERIALS AND METHODS The analyses included 117 female nurses and midwives who work shifts. They filled in the 16-item Effort-Reward Imbalance Questionnaire (ERIQ) assessing occupational stress, the Insomnia Severity Index (ISI), the Patient Health Questionnaire (PHQ-9, the question about sleep was excluded from the analyses), the Generalized Anxiety Disorder Assessment (GAD-7), and the 16-item Oldenburg Burnout Inventory (OLBI) consisting of two scales - Disengagement and Exhaustion (OLBI-D and OLBI-E). RESULTS Insomnia partially mediated the association of the effort-reward imbalance ratio with depression, anxiety and the exhaustion dimension of burnout. We found no association of insomnia symptoms with the depersonalization dimension of burnout, but the effort-reward imbalance ratio was associated with the depersonalization scale. CONCLUSION The results showed that occupational stress has varying degrees of influence on mental health, partly depending on the severity of insomnia symptoms among nurses and midwives who work shifts.
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Affiliation(s)
- Katarzyna Gustavsson
- Department of Clinical Neurophysiology, Sleep Medicine Center, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Wojciech Jernajczyk
- Department of Clinical Neurophysiology, Sleep Medicine Center, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Adam Wichniak
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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16
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Trinkoff AM, Baldwin CM, Chasens ER, Dunbar-Jacob J, Geiger-Brown J, Imes CC, Landis CA, Patrician PA, Redeker NS, Rogers AE, Scott LD, Todero CM, Tucker SJ, Weinstein SM. CE: Nurses Are More Exhausted Than Ever: What Should We Do About It? Am J Nurs 2021; 121:18-28. [PMID: 34743129 DOI: 10.1097/01.naj.0000802688.16426.8d] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
ABSTRACT For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.
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Affiliation(s)
- Alison M Trinkoff
- Alison M. Trinkoff is a professor at the University of Maryland School of Nursing, Baltimore. Carol M. Baldwin is professor emeritus and a Southwest Borderlands Scholar at Arizona State University's Edson College of Nursing and Health Innovation, Phoenix. Eileen R. Chasens is a professor and chair of the Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, where Jacqueline Dunbar-Jacob is dean and a distinguished service professor and Christopher C. Imes is an assistant professor. Now retired, at the time of this writing Jeanne Geiger-Brown was a professor and associate dean for research at the George Washington University School of Nursing, Washington, DC. Carol A. Landis is a professor emeritus at the University of Washington School of Nursing, Seattle. Patricia A. Patrician is a professor and the Rachel Z. Booth Endowed Chair at the University of Alabama at Birmingham School of Nursing, and a retired U.S. Army colonel. Nancy S. Redeker is the Beatrice Renfield Term Professor of Nursing at the Yale University School of Nursing, New Haven, CT. Ann E. Rogers is a professor at the Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta. Linda D. Scott is a professor and dean of the University of Wisconsin-Madison School of Nursing. Catherine M. Todero is dean of the College of Nursing and vice provost of Health Sciences at Creighton University, Omaha, NE, and Phoenix, AZ. Sharon J. Tucker is the Grayce Sills Endowed Professor in Psychiatric-Mental Health Nursing and director of the Translational/Implementation Research Core at the Ohio State University College of Nursing, Columbus. Sharon M. Weinstein is chief executive officer of the Global Education Development Institute, and SMW Group LLC, North Bethesda, MD, and a clinical assistant professor at the College of Nursing, University of Illinois, Chicago. This article was a collaborative effort by the Fatigue Subgroup of the Health Behavior Expert Panel, American Academy of Nursing. The authors acknowledge Claire C. Caruso, PhD, RN, a research health scientist at the National Institute for Occupational Safety and Health, for her help in reviewing the manuscript. Contact author: Alison M. Trinkoff, . The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com
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Guzys D, Tori K, Mather C. Moral distress in community health nursing practice. Aust J Prim Health 2021; 27:350-353. [PMID: 34247698 DOI: 10.1071/py20276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
Contemporary sociopolitical circumstance impedes the delivery of primary health care in keeping with its underlying philosophy and tenets. Skills to negotiate the maintenance of best practice and quality care in an evolving practice environment are fundamental to nursing. Nurse education needs to incorporate the ideals of best practice ideology to ensure that all are prepared to negotiate the realities of nursing practice. In this discussion paper the experience of moral distress by community health nurses is used to illustrate why skills in political advocacy and action are equally essential as clinical skills in nurse education and professional practice.
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Affiliation(s)
- Diana Guzys
- School of Nursing, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston, Tas. 7250, Australia; and Corresponding author.
| | - Kathleen Tori
- School of Nursing, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston, Tas. 7250, Australia
| | - Carey Mather
- School of Nursing, College of Health and Medicine, University of Tasmania, Locked Bag 1322, Launceston, Tas. 7250, Australia
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18
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Labrague LJ, De Los Santos JAA. Prevalence and predictors of coronaphobia among frontline hospital and public health nurses. Public Health Nurs 2021; 38:382-389. [PMID: 33226158 PMCID: PMC7753466 DOI: 10.1111/phn.12841] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 10/24/2020] [Accepted: 11/04/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To determine the prevalence as well as the predictors of coronaphobia in frontline hospital and public health nurses. DESIGN This study used a cross-sectional research study involving 736 nurses working in COVID-19 designated hospitals and health units in Region 8, Philippines. Four structured self-report scales were used, including the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Perceived Social Support Questionnaire, and the single-item measure for perceived health. RESULTS The prevalence of coronaphobia was 54.76% (n = 402): 37.04% (n = 130) in hospital nurses and 70.91% (n = 273) in public health nurses. Additionally, nurses' gender (β = 0.148, p < .001), marital status (β = 0.124, p < .001), job status (β = 0.138, p < .001), and personal resilience (β = -0.167, p = .002) were identified as predictors of COVID-19 anxiety. A small proportion of nurses were willing (19.94%, n = 70) and fully prepared (9.40%, n = 33) to manage and care for coronavirus patients. CONCLUSION Coronaphobia is prevalent among frontline Filipino nurses, particularly among public health nurses. Interventions to address coronaphobia among frontline nurses in the hospital and community should consider the predictors identified. By increasing personal resilience in nurses through theoretically driven intervention, coronaphobia may be alleviated.
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Zhu Y, He MM, Zhu JM, Huang L, Li BK. Motives for Empathy among Clinical Nurses in China: A Qualitative Study. J Korean Acad Nurs 2021; 50:778-786. [PMID: 33441525 DOI: 10.4040/jkan.20123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to explore the motives of clinical nurses for experiencing empathy with patients and their families based on a self-determination theory framework. METHODS Semi-structured face-to-face interviews with twenty-one nurses at four tertiary hospitals in Anhui, China, were conducted, recorded and transcribed. A content analysis with a directed approach was performed. RESULTS An analysis of the interview transcripts revealed three categories of empathy motivation: autonomous motivation, controlled motivation and a lack of empathy motivation. Autonomous motivation included personal interests, enjoyment and a sense of value, pure altruism, assimilation, and recognition of the importance of empathy. Controlled motivation highlighted pressures from oneself and others, the possibility of tangible or intangible rewards, and avoidance of adverse effects. Finally, a lack of empathy motivation referred to a lack of intention for empathy and denial of the value of empathy. CONCLUSION This study provides a deep understanding of the motives underlying empathy in nurses. The results reveal the reasons for empathy and may support the development of effective strategies to foster and promote empathy in nurses.
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Affiliation(s)
- Yu Zhu
- Clinical Nursing Department, Nursing School, Anhui University of Chinese Medicine, Hefei, China
| | - Ming Mei He
- Obstetrics Department, Anhui Women and Child Health Care Hospital, Hefei, China
| | - Ji Min Zhu
- School of Traditional Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China
| | - Li Huang
- Clinical Nursing Department, Nursing School, Anhui University of Chinese Medicine, Hefei, China
| | - Bai Kun Li
- School of Traditional Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China.
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Muhamad Robat R, Mohd Fauzi MF, Mat Saruan NA, Mohd Yusoff H, Harith AA. Why so stressed? A comparative study on stressors and stress between hospital and non-hospital nurses. BMC Nurs 2021; 20:2. [PMID: 33390159 PMCID: PMC7780689 DOI: 10.1186/s12912-020-00511-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/29/2020] [Indexed: 05/30/2023] Open
Abstract
Background Stress, which can be attributed to household and workplace stressors, is prevalent among nurses. However, these stressors’ attribution may differ between hospital and non-hospital nurses. It is currently unknown whether there are significant differences in the sociodemographic and occupational characteristics between hospital and non-hospital nurses which may potentially influence the type and magnitude of stressors, and subsequently the stress status. Therefore, this study aims to estimate the prevalence of stress and compare the roles of sociodemograhic characteristics, occupational profiles, workplace stressors and household stressors in determining the stress status between hospital and non-hospital female nurses in Malaysia. Methods This cross-sectional study was conducted among randomly-selected 715 female nurses in Malaysia using pencil-and-paper self-reported questionnaires. Results The majority of participants were ever married (87.0%), having children (76.2%), and work in hospital setting (64.8%). The level of household stressors was generally similar between hospital and non-hospital nurses. However, hospital nurses significantly perceived higher level of workplace stressors. Shift work is significantly associated with higher level of household and workplace stressors among nurses in both groups. The level of stress was significantly higher among hospital nurses. Both household and workplace stressors explained about 40% of stress status in both hospital and non-hospital nurses. Conclusion Hospital nurses are at higher risk of having stressors and stress as compared to non-hospital nurses, probably due to higher proportion of them involved in shift work. Hospital nurses should be given high priority in mitigating stress among nurses.
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Affiliation(s)
- Rosnawati Muhamad Robat
- Occupational and Environmental Health Unit, Selangor State Health Department, No 1 Wisma Sunway, Jalan Tengku Ampuan Zabedah C 9/C, Seksyen 9, 40100, Shah Alam, Selangor, Malaysia
| | - Mohd Fadhli Mohd Fauzi
- Ministry of Health Malaysia, Block E1, E3, E6, E7 & E10, Complex E, Federal Government Administrative Centre, 62590, Putrajaya, Malaysia.,Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
| | - Nur Adibah Mat Saruan
- Ministry of Health Malaysia, Block E1, E3, E6, E7 & E10, Complex E, Federal Government Administrative Centre, 62590, Putrajaya, Malaysia.,Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia
| | - Hanizah Mohd Yusoff
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia.
| | - Abdul Aziz Harith
- Occupational Health Research Centre, Institute for Public Health Malaysia, Blok B5 & B6, Kompleks NIH, No1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, 40170, Shah Alam, Selangor, Malaysia
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21
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Rushton CH, Swoboda SM, Reller N, Skarupski KA, Prizzi M, Young PD, Hanson GC. Mindful Ethical Practice and Resilience Academy: Equipping Nurses to Address Ethical Challenges. Am J Crit Care 2021; 30:e1-e11. [PMID: 33385208 DOI: 10.4037/ajcc2021359] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Ethical challenges in clinical practice significantly affect frontline nurses, leading to moral distress, burnout, and job dissatisfaction, which can undermine safety, quality, and compassionate care. OBJECTIVES To examine the impact of a longitudinal, experiential educational curriculum to enhance nurses' skills in mindfulness, resilience, confidence, and competence to confront ethical challenges in clinical practice. METHODS A prospective repeated-measures study was conducted before and after a curricular intervention at 2 hospitals in a large academic medical system. Intervention participants (192) and comparison participants (223) completed study instruments to assess the objectives. RESULTS Mindfulness, ethical confidence, ethical competence, work engagement, and resilience increased significantly after the intervention. Resilience and mindfulness were positively correlated with moral competence and work engagement. As resilience and mindfulness improved, turnover intentions and burnout (emotional exhaustion and depersonalization) decreased. After the intervention, nurses reported significantly improved symptoms of depression and anger. The intervention was effective for intensive care unit and non-intensive care unit nurses (exception: emotional exhaustion) and for nurses with different years of experience (exception: turnover intentions). CONCLUSIONS Use of experiential discovery learning practices and high-fidelity simulation seems feasible and effective for enhancing nurses' skills in addressing moral adversity in clinical practice by cultivating the components of moral resilience, which contributes to a healthy work environment, improved retention, and enhanced patient care.
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Affiliation(s)
- Cynda Hylton Rushton
- Cynda Hylton Rushton is the Anne and George L. Bunting Professor of Clinical Ethics at Berman Institute of Bioethics and a professor of nursing and pediatrics, Johns Hopkins University School of Nursing and School of Medicine, Baltimore, Maryland
| | - Sandra M. Swoboda
- Sandra M. Swoboda is the Department of Surgery research program coordinator and prelicensure masters entry program simulation coordinator/educator, Johns Hopkins University School of Nursing and School of Medicine
| | - Nancy Reller
- Nancy Reller is president of Sojourn Communications, McLean, Virginia
| | - Kimberly A. Skarupski
- Kimberly A. Skarupski is associate dean for faculty development at the School of Medicine, associate professor in the Division of Geriatric Medicine and Gerontology, and associate professor of epidemiology at Bloomberg School of Public Health, Johns Hopkins University
| | - Michelle Prizzi
- Michelle Prizzi is research and educational program coordinator at Berman Institute of Bioethics, Johns Hopkins University
| | - Peter D. Young
- Peter D. Young is a DPhil candidate in population health at Ethox Centre and Wellcome Centre for Ethics and Humanities, University of Oxford, England
| | - Ginger C. Hanson
- Ginger C. Hanson is an assistant professor at Johns Hopkins School of Nursing
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Chemali Z, Ezzeddine FL, Gelaye B, Dossett ML, Salameh J, Bizri M, Dubale B, Fricchione G. Burnout among healthcare providers in the complex environment of the Middle East: a systematic review. BMC Public Health 2019; 19:1337. [PMID: 31640650 PMCID: PMC6805482 DOI: 10.1186/s12889-019-7713-1] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/30/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Burnout is a syndrome characterized by emotional exhaustion, increased depersonalization, and a diminished sense of personal accomplishment due to chronic emotional stress at work. Burnout impacts job satisfaction, job performance, vulnerability to illnesses, and interpersonal relationships. There is a gap in the systematic data on the burden of burnout among healthcare professionals from different sectors of healthcare in Middle Eastern countries. Our objective was to examine the burden of burnout among healthcare providers in the Middle East, how it was assessed, which sectors were included, and what interventions have been used. METHODS Articles were found through a systematic review of search results including PubMed, Web of Science (Thomson Reuters), and PsycINFO (EBSCO) using search terms reflecting burnout in Middle Eastern countries among populations of healthcare providers. Studies were included if they examined a quantitative measure of burnout among healthcare providers in the Middle East. RESULTS There were 138 articles that met our inclusion criteria for this systematic review. Studies focused on burnout in the Middle East among physicians (N = 54 articles), nurses (N = 55), combined populations of healthcare workers (N = 22), and medical students (N = 7). The Maslach Burnout Inventory was the most common tool to measure burnout. Burnout is common among physicians, nurses, and other healthcare professionals, with prevalence estimates predominantly ranging between 40 and 60%. Burnout among healthcare providers in the Middle East is associated with characteristics of their work environments, exposure to violence and terror, and emotional distress and low social support. CONCLUSIONS Burnout is highly prevalent among healthcare providers across countries in the Middle East. Previous studies examining burnout in this region have limitations in their methodology. More thoroughly developed epidemiologic studies of burnout are necessary. Health system strengthening is needed in a region that has endured years of ongoing conflict, and there is an urgency to design and implement programs that tackle burnout among health professionals.
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Affiliation(s)
- Z. Chemali
- Departments of Neurology and Psychiatry, Massachusetts General Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - F. L. Ezzeddine
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - B. Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA USA
| | - M. L. Dossett
- Benson-Henry Institute for Mind Body Medicine and, Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
| | - J. Salameh
- Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon
| | - M. Bizri
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - B. Dubale
- Department of Psychiatry, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
| | - G. Fricchione
- Department of Psychiatry, Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
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